scholarly journals Assessment of the Cost of the Mediterranean Diet in a Low-Income Region: Adherence and Relationship with Available Incomes

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Alessia Rubini ◽  
Cristina Vilaplana-Prieto ◽  
Marta Flor-Alemany ◽  
Lorena Yeguas-Rosa ◽  
Miriam Hernández-González ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Low Income ◽  
Urban Areas ◽  
Economic Cost ◽  
Population Based ◽  
Disposable Income ◽  
Median Cost ◽  
Monthly Cost ◽  
The Mediterranean ◽  
The Cost

Abstract Background The Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied. The objective of the present study is to explore the cost and adherence of a low-income region population to the MD and its relationship with income. Methods A population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the municipalities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura (Spain). Average monthly cost of each product included in the MD was computed and related to adherence to the MD using the Panagiotakos Index and average disposable income. Results The monthly median cost was 203.6€ (IQR: 154.04-265.37). Food-related expenditure was higher for men (p<0.001), age cohort between 45 and 54 years (p<0.013) and those living in urban areas (p<0.001). A positive correlation between food-related expenditure and the MD adherence was found. Monthly median cost represents 15% of average disposable income, ranging between 11% for the group with low MD adherence and 17% for the group with high MD adherence. Conclusions The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern. Given that the estimated monthly cost is similar to that of other Spanish regions with a higher income level, the economic effort required to be able to afford the Mediterranean diet is higher. This may represent a barrier to access, which should be analyzed in detail by public decision-makers.

scholarly journals Assessment of the Cost of the Mediterranean Diet in a Low-Income Region: Adherence and Relationship with Available Incomes

2021 ◽  
Author(s):  
Alessia Rubini ◽  
Cristina Vilaplana Prieto ◽  
Marta Flor-Alemany ◽  
Lorena Yeguas-Rosa ◽  
Miriam Hernández-González ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Low Income ◽  
Urban Areas ◽  
Economic Cost ◽  
Population Based ◽  
Male Population ◽  
Population Based Study ◽  
Per Capita ◽  
The Mediterranean ◽  
The Cost

Abstract BackgroundThe Mediterranean Diet (MD) is recognized as heart-healthy, but the economic cost associated with this type of diet has scarcely been studied.AimThe objective of the present study was to explore the cost and adherence of the low-income region population to the MD and its relationship with available incomes.MethodsA population-based study was carried out on 2,833 subjects between 25 and 79 years of age, 54% women, selected at random from the communities of Vegas Altas, La Siberia and La Serena in the province of Badajoz, Extremadura, Spain. The average cost of each product included in the MD and monthly expenditure were calculated. The expenditure was related to the degree of adherence to the MD (the Panagiotakos Index) and to the incomes of the participants.ResultsThe monthly median cost was 203.6 euros (IQR 154.04-265.37). Food-related expenditure was higher among the male population (p<0.001) of between 45 and 54 years of age (p<0.013) and living in urban areas (p<0.001). A positive correlation between food-related expenditure and the MD adherence was found. Expenditure represents 15% of total incomes, ranging from 11% for the group with a low MD adherence to 17% for the group with a high MD adherence.Conclusions The monthly cost of the MD was positively correlated with the degree of adherence to this dietary pattern, and is similar to that of other regions of Spain with higher per capita income, which entails a greater expenditure for equal adherence to the MD.

Evaluation of the mediterranean diet cost in Extremadura: adherence and relationship with available income

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Rubini ◽  
C Vilaplana Prieto ◽  
L Yeguas Rosa ◽  
M Flor-Alemany ◽  
J Felix Garcia ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Low Income ◽  
Urban Areas ◽  
Geographical Area ◽  
Developed Countries ◽  
Alcoholic Beverages ◽  
Monthly Cost ◽  
National Budget ◽  
The Mediterranean ◽  
The Cost

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Carlos III Health Institute - Spain Background Cardiovascular diseases are the leading cause of death in developed countries. In this context, the Mediterranean diet (MD) is widely recognized as cardioprotective, although its implementation cost has been little studied and rarely employed as an argument for debate. Although previous Spanish studies have corroborated a higher monetary cost associated with increased adherence to the MD, there exist large disparities among studies, and none of them has related the cost of MD to available income, which is highly relevant for assessing the degree of affordability by families. Purpose The aim of this study is twofold. First, to estimate the cost and degree of adherence of the MD in a population of Extremadura. Second, to provide evidence on the cost of the MD in relation to available incomes. Methods A population study including 2.833 subjects between 25 and 79 years old (54% women), randomly selected from Don Benito-Villanueva de la Serena (Badajoz, Spain). Diet questionnaire contained 175 food items and 7 items related to alcoholic beverages. Consumption frequencies were translated in terms of grams or millilitres. Price for each item was obtained using price supermarket comparators from the same geographical area. Total monthly cost was obtained using monthly quantities consumed and the price of each category.  Final cost was related to Panagiotakos adherence degree and to available income. Data of available income was obtained from the Income Tax Statistics by municipality. Results Median monthly cost was EUR 203.63 (IQR 154.04-265.37): 216.91 for men and 191.22 for women. Median monthly cost per age cohort showed an inverted U-shape, with a maximum in the 45-54 years-old cohort (EUR 212.1; IQR 155.47-274.63) and a minimum for the 75-79 years-old cohort (EUR 179; IQR 130.21-224.99). Median monthly cost was very similar for primary, secondary and higher educational levels (208.18, 206.57 and 205.70, respectively), but 14% lower for those without primary studies. MD cost was lower in rural compared with urban areas (188 versus 223 euros, respectively) The percentage of population showing a high MD adherence was 59% whereas the percentage with a low adherence was 12%. The cost associated with a high MD adherence was EUR 228.38. The average cost represents 14% of the available income, ranging from 10.5% for the group with low MD adherence, to 15.72% for the group with a high adherence. Conclusions Higher adherence to the MD can reach almost 20% of the available income. This can lead to low-income families opting for cheaper, energy-dense, and consequently, less healthy dietary patterns. Emphasis should be placed on education strategies to recreate the MD at an affordable price or to introduce changes to consumer taxes (VAT) that favor DM pattern.

Adhering to a Mediterranean diet in a Mediterranean country: an excess cost for families?

2021 ◽  
pp. 1-24
Author(s):  
Ricardo Alves ◽  
Carla Lopes ◽  
Sara Rodrigues ◽  
Julian Perelman
Keyword(s):  
Mediterranean Diet ◽  
Food Group ◽  
Food Prices ◽  
Mediterranean Country ◽  
Linear Regression Models ◽  
Middle Income ◽  
Diet Cost ◽  
The Mediterranean ◽  
The Cost ◽  
Activity Survey

Abstract Background: Adherence to the Mediterranean diet has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the Mediterranean diet. Methods: We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n=3,591). Diet expenditures were estimated by attributing a retail price to each food group and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65% of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Results: Greater adherence to the MD was associated with a 21.2% (p< 0.05) rise in total dietary cost, which accounts for more 0.59€ in mean daily costs when compared with low adherence. High adherence individuals (vs. low adherence) had higher absolute mean daily costs with fish (0.62€/+285.8%; p< 0.05), fruits (0.26€/+115.8%; p< 0.05), and vegetables (0.10€/+100.9%; p< 0.05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Conclusions: Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population’s diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.

At what cost is performance-based financing implemented? Novel evidence from Malawi

2019 ◽  
Vol 34 (4) ◽  
pp. 282-288 ◽  
Author(s):  
Manuela De Allegri ◽  
Chris Makwero ◽  
Aleksandra Torbica
Keyword(s):  
Low Income ◽  
Economic Cost ◽  
Personnel Cost ◽  
Cost Category ◽  
Implementation Phase ◽  
Personnel Costs ◽  
Performance Based Financing ◽  
Implementation Costs ◽  
The Cost ◽  
Low Income Setting

Abstract Our study estimated the full economic cost of implementing performance-based financing [PBF, the Support for Service Delivery Integration Performance-Based Incentives (SSDI-PBI) programme], as a means of first introducing strategic purchasing in a low-income setting, Malawi. Our analysis distinguished design from implementation costs and traces costs across personnel and non-personnel cost categories over the 2012–15 period. The full cost of the SSDI-PBI programme amounted to USD 3 402 187, equivalent to USD 6.46 per targeted beneficiary. The design phase accounted for about one-third (USD 1 161 332) of the total costs, while the incentives (USD 1 140 436) represented about one-third of the total cost of the intervention and about half the cost of the implementation phase. With a cost of USD 1 605 178, personnel costs represented the dominant cost category. Our study indicated that the introduction of PBF entailed consumption of a substantial amount of resources, hence representing an important opportunity cost for the health system.

scholarly journals BURDEN OF THERAPY IN PATIENTS SUFFERING FROM DIABETES MELLITUS AND HYPERTENSION

2017 ◽  
Vol 9 (5) ◽  
pp. 210
Author(s):  
Mali Kalpana Ramanna ◽  
Ruckmani A. ◽  
Siddharam S. Janti ◽  
Madhavi Eerike ◽  
R. Lakshmipathy Prabu
Keyword(s):  
Diabetes Mellitus ◽  
Low Income ◽  
Occupational Status ◽  
Income Group ◽  
Psychological Burden ◽  
Monthly Cost ◽  
Validated Questionnaire ◽  
Treatment Of Diabetes ◽  
The Cost ◽  
Post Hoc

Objective: To estimate a) monthly expenditure for treatment of diabetes mellitus (DM), hypertension (HTN) and both (DM+HTN) and b) economic burden (EB) and psychological burden (PB) of therapy of DM, HTN and DM+HTN.Methods: An observational questionnaire-based study was conducted among 180 patients. The monthly cost of drug therapy was assessed based on the drugs they were taking and the cost of individual drugs. The EB and PB were assessed using a validated questionnaire and data analysed by ANOVA followed by post hoc test.Results: Among 216 patients who were interviewed, 180 fulfilled the selection criteria. Among 180, 75 had DM, 40 HTN and 65 had both. Prevalence of DM and DM+HTN was higher among females and of HTN equal among males and females. The average total monthly cost of therapy for DM was INR 2077, for HTN INR 1464 and for DM+HTN INR 2269.Significant correlation was found between income and percentage of expenditure (p<0.001) in all the groups. The PB was found to correlate with low income (p<0.001), poor education (p<0.05) occupation (p<0.01) in DM+HTN and number of tablets (p<0.01) in DM and DM+HTN groups.Conclusion: The cost of therapy was higher for DM+HTN and DM. The percentage of expenditure was higher in low-income group and burden of therapy was directly proportional to the number of tablets, poor educational and occupational status; and inversely proportional to income.

scholarly journals Sustainable dietetic models in Europe: the Mediterranean diet as case study

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
F Scazzina
Keyword(s):  
Mediterranean Diet ◽  
Food System ◽  
Dietary Habits ◽  
Well Being ◽  
Overweight And Obesity ◽  
Lifestyle Changes ◽  
Total Energy Consumption ◽  
Adequate Diet ◽  
The Mediterranean ◽  
The Cost

Abstract More than five years since the global commitment to the 2030 Agenda for Sustainable Development, 690 million people lack sufficient food and economic projections suggest that the COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished. Meanwhile, 1.3 billion tons of food are wasted globally each year, utilizing 38% of total energy consumption in the global food system. Child and adult overweight and obesity are increasing in almost all countries, and on a global level the cost of a healthy diet is 60% higher than the cost of a nutrient adequate diet, and almost 5 times the cost of an energy sufficient diet. The Mediterranean Diet is one of the recognized models of healthy and sustainable diets. This model has proven to promote longevity and well-being, not only by considering specific food items and dietary patterns, but also taking into account the culture and the history of populations living in that region, as well as social aspects such as tradition and conviviality. Moreover, it is strongly tied to a gastronomic background that links health with enjoyment. This may be extremely important for the implementation of feasible programs for the prevention of chronic non communicable diseases. In fact, long lasting lifestyle changes are difficult to achieve and, although health motivations may lead to satisfactory dietary compliance in the short term, pleasure remains an important determinant of any dietary change that is intended to last. While keeping traditional dietary habits at European level, the main principles of the Mediterranean diet could be taken into account to identify key features that ensure both health benefits and sustainable impact on environment. Assessing the sustainability of these products can be an effective operational approach for preserving and promoting a Mediterranean-type dietary pattern in the European region.

scholarly journals The Effect of Initiation of Anti-TNF Therapy on the Subsequent Direct Health Care Costs of Inflammatory Bowel Disease

2019 ◽  
Vol 25 (10) ◽  
pp. 1718-1728 ◽  
Author(s):  
Laura E Targownik ◽  
Eric I Benchimol ◽  
Julia Witt ◽  
Charles N Bernstein ◽  
Harminder Singh ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Expenditures ◽  
Population Based ◽  
World Population ◽  
Median Cost ◽  
Future Health ◽  
Before And After ◽  
Future Health Care ◽  
The Cost ◽  
The Impact

Abstract Background Anti–tumor necrosis factor (anti-TNF) drugs are highly effective in the treatment of moderate-to-severe Crohn’s disease (CD) and ulcerative colitis (UC), but they are very costly. Due to their effectiveness, they could potentially reduce future health care spending on other medical therapies, hospitalization, and surgery. The impact of downstream costs has not previously been quantified in a real-world population-based setting. Methods We used the University of Manitoba IBD Database to identify all persons in a Canadian province with CD or UC who received anti-TNF therapy between 2004 and 2016. All inpatient, outpatient, and drug costs were enumerated both in the year before anti-TNF initiation and for up to 5 years after anti-TNF initiation. Costs before and after anti-TNF initiation were compared, and multivariate linear regression analyses were performed to look for predictors of higher costs after anti-TNF initiation. Results A total of 928 people with IBD (676 CD, 252 UC) were included for analyses. The median cost of health care in the year before anti-TNF therapy was $4698 for CD vs $6364 for UC. The median cost rose to $39,749 and $49,327, respectively, in the year after anti-TNF initiation, and to $210,956 and $245,260 in the 5 years after initiation for continuous anti-TNF users. Inpatient and outpatient costs decreased in the year after anti-TNF initiation by 12% and 7%, respectively, when excluding the cost of anti-TNFs. Conclusions Direct health care expenditures markedly increase after anti-TNF initiation and continue to stay elevated over pre-initiation costs for up to 5 years, with only small reductions in the direct costs of non-drug-related health care.

scholarly journals A Retrospective Cross-Sectional Population-Based Study on Prenatal Levels of Adherence to the Mediterranean Diet: Maternal Profile and Effects on the Newborn

2018 ◽  
Vol 15 (7) ◽  
pp. 1530 ◽  
Author(s):  
Isabel Peraita-Costa ◽  
Agustín Llopis-González ◽  
Alfredo Perales-Marín ◽  
Ferran Sanz ◽  
Agustín Llopis-Morales ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Mediterranean Diet ◽  
Daily Intake ◽  
Clinical History ◽  
Population Based ◽  
Multiple Gestation ◽  
Cross Sectional ◽  
Folic Acid Supplements ◽  
The Mediterranean

The Mediterranean diet (MD) is a dietary pattern with important benefits. The objectives of this study were to assess the adherence to the MD among pregnant women in Valencia (Spain) and characterize the pregnant women according to their level of adherence. Finally, we aimed to examine the role of MD adherence during pregnancy in the anthropometric development of the newborn. The study included 492 pregnant women who were followed at La Fe Hospital in 2017. The self-administered “Kidmed” questionnaire for data collection on dietary information evaluation was used and a clinical history review of mothers and newborns was performed. Two groups of mothers were identified: those with low adherence (LA) and optimal adherence (OA). The study revealed that 40.2% of the women showed LA to the MD. The newborns born to these women presented a higher risk of being small for gestational age (SGA) {adjusted odds ratio (aOR) = 1.68; 95% confidence interval (CI) 1.02–5.46} when adjusting for parental body mass index (BMI) and multiple gestation, but not when adjusting for all significant possible confounders (aOR = 2.32; 95% CI 0.69–7.78). The association between MD and SGA was not significantly affected by the use of iron and folic acid supplements (aOR = 2.65; 95% CI 0.66–10.65). The profile of the pregnant woman with LA is that of a young smoker, with a low level of education and a low daily intake of dairy products. These results suggest that LA to the MD is not associated with a higher risk of giving birth to a SGA newborn.

scholarly journals KAJIAN LOKASI POTENSIAL PENGEMBANGAN PERUMAHAN TERJANGKAU DI KOTA SEMARANG

2017 ◽  
Vol 5 (2) ◽  
pp. 104
Author(s):  
Hajar Annisa Abdurahman ◽  
Iwan Rudiarto
Keyword(s):  
Information System ◽  
Affordable Housing ◽  
Low Income ◽  
Urban Areas ◽  
Housing Development ◽  
Analysis Method ◽  
Human Settlement ◽  
Result Show ◽  
The Cost ◽  
Spatial Analysis Method

Human settlements supply has always been a problem in urban areas, particularly for the low-earners. There are few aspects to do in house procurement, such as location that will determine the cost of housing. Hence, this research aims to determine potential location to be developed as affordable housing for low-income people in Semarang. This research applied spatial analysis method based on Geographic Information System (GIS). The analysis results that only around 5,85% of allocated human settlement area in Semarang City is potential to be developed as affordable housing. In this study, the result show that in terms of location for affordable housing development, accessibility factor can determine the location with considering the particular planning standards.

scholarly journals Validation of the Telephone-Administered Version of the Mediterranean Diet Adherence Screener (MEDAS) Questionnaire

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1511 ◽  
Author(s):  
Maria João Gregório ◽  
Ana M. Rodrigues ◽  
Clara Salvador ◽  
Sara S. Dias ◽  
Rute D. de Sousa ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Large Population ◽  
Population Based ◽  
Validity And Reliability ◽  
Face To Face ◽  
Portuguese Version ◽  
Diet Adherence ◽  
Mediterranean Diet Adherence ◽  
The Face ◽  
The Mediterranean

A 14-Item Mediterranean Diet Adherence Screener (MEDAS) questionnaire was developed and validated in face-to-face interviews, but not via telephone. The aims of this study were to evaluate the validity and reliability of a telephone-administered version of the MEDAS as well as to validate the Portuguese version of the MEDAS questionnaire. A convenience community-based sample of adults (n = 224) participated in a three-stage survey. First, trained researchers administered MEDAS via a telephone. Second, the Portuguese version of Food Frequency Questionnaire (FFQ), and MEDAS were administered in a semi-structured face-to-face interview. Finally, MEDAS was again administered via telephone. The telephone-administered MEDAS questionnaire was compared with the face-to-face-version using several metrics. The telephone-administered MEDAS was significantly correlated with the face-to-face-administered MEDAS [r = 0.805, p < 0.001; interclass correlation coefficient (ICC) = 0.803, p < 0.001] and showed strong agreement (k = 0.60). The MEDAS scores that were obtained in the first and second telephone interviews were significantly correlated (r = 0.661, p < 0.001; ICC = 0.639, p < 0.001). The overall agreement between the Portuguese version of MEDAS and the FFQ-derived Mediterranean diet adherence score had a Cohen’s k = 0.39. The telephone-administered version of MEDAS is a valid tool for assessing the adherence to the Mediterranean diet and acquiring data for large population-based studies.

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